30 Nov 2021

Chief public relations officer at the ministry, Dr Christopher Nyanga says the country has affirmed, by engaging new strategies, its commitment to ending the AIDS epidemic as a public health threat by 2030. 

Responding to a BOPA questionnaire, Dr Nyanga said Botswana was keeping up with global recommendations that include the adoption of the 95-95-95 target, which aims to have contained HIV infections by 2023, to control the spread of HIV and AIDS. 

Announced by UNAIDS in 2014, the ambitious 95-95-95 strategy was intended to end the AIDS epidemic by 2030 by achieving 95 per cent of diagnosed among all people living with HIV, 95 per cent among the diagnosed, enrolled on antiretroviral therapy and 95 per cent virally suppressed among the treated. 

“For the 95-95-95 target, UNAIDS projects Botswana to be at 92-95-98,” he said, adding that adherence to treatment had always been over 95 per cent. 

He said the strategy was in line with the Botswana National Strategy Framework (NSF) and the implementation of the five pillars of HIV prevention, which include programmes for adolescent girls and young women, plan for key populations, voluntary medical male circumcision, Pre Exposure Prophylaxis-PrEP and condoms. 

He said strategies intended to achieve the set goals for Treat All, where people living with HIV are given treatment early, free HIV treatment for, including non-nationals living in Botswana, HIV self-testing and active partner notification. Dr Nyanga said according to UNAIDS projections, 375 896 people were living with HIV in Botswana, while the Ministry of Health and Wellness data, shows that at the end of June 2021, there were 335 328 enrolled in ARV therapy. 

He said the country had adopted various strategies such as same day enrolment and fast tracking of Anti-Retroviral Therapy (ART) initiation within seven days of HIV diagnosis, multi-month scripting (six months) and three months dispensing of ARV medication, while care has been decentralised to make ARV therapy available in all health facilities. 

He said the use of treatment adherence partners dubbed the ‘buddy model’, and public sensitisation on the importance of ARV therapy, through various media, were some of the strategies in place.  Overall, Dr Nyanga said adherence to ARV therapy in Botswana had been good over the years, adding that the introduction of safer medication, with less side effects and better formulations (once-a-day tablets) and ARV multi-month dispensing, have significantly contributed in improving adherence to ARV therapy. 

He confirmed that unforeseen circumstances were a stumbling block to the positive campaign, citing that the COVID-19 pandemic significantly disrupted provision of HIV services as more pressure was exerted on the already strained health care system. 

He said the challenges were related, but not limited to reduced partner support and funding due to the devastating effects of the COVID-19 pandemic on all sectors of the economy. 

However, Dr Nyanga said the Ministry of Health and Wellness, in collaboration with its various stakeholders, would continue with public education to ensure that everyone remained cautious and avoided risky behaviour likely to spread HIV. 

“More emphasis is currently being put on sensitising the public on prevention for those who are HIV negative and treatment for those living with HIV,” he said. 

Although traditional ways of campaigning that thrive on mass gatherings were less visible due to measures that were put in place to contain the COVID-19 pandemic, he assured that HIV and AIDS campaigns were taking place through various technologically accessed platforms. 

“In addition, National AIDS and Health Promotion Agency (NAHPA) actively works with development partners and the civil society to promote HIV awareness for prevention, treatment and care,” he said. 

Dr Nyanga said the Botswana Prevention of Mother To Child Transmission (PMTCT) of HIV programme had always been one of the most successful stories in the world. 

“As per the Ministry of Health and Wellness data, the current rate of mother to child transmission of HIV is around 0.6 per cent and ART enrolment among pregnant women is around 98 per cent,” he said. However, Dr Nyanga said there was a challenge of a limited number of pregnant women enrolling on PMTCT. 

“A few pregnant women not enrolling on PMTCT are those from remote, hard-to-reach locations, with somehow low level of education.  The ministry is making efforts to visit the locations and sensitise on the importance of enrolling in the programme,” he said. 

He said Botswana, like the rest of the world, had been equally affected by the challenge of new HIV infections, with adolescent girls and young women accounting for 75 per cent of new infections. 

“Young girls remain vulnerable to HIV infection because of, among others; age, desperation and vulnerability to transactional sex, peer pressure, stigma and discrimination, as well as harmful social and gender norms, gender inequality and unequal power dynamics,” he said. 

He, however, said a number of programmes such as youth friendly clinics, DREAMS, programmes on HIV prevention (HIV Pre-Exposure Prophylaxis) were in place to equip the youth with knowledge on HIV and AIDS. Dr Nyanga said biomedical programmes, which included HIV testing, TB screening, STI screening (for oral, vaginal and anal sex), Sexual Reproductive Health Services (including family planning), provision of male and female condoms, were offered to HIV vulnerable groups. 

He also said behavioural change programmes including Social Behaviour Communication Change (SBCC) programmes on stigma and discrimination; risk reduction programme (focusing on alcohol, drugs and tobacco abuse) and education on multiple sexual partners, age appropriate Comprehensive Sexuality Education (CSE) and peer education support, including treatment adherence clubs, were also in place to offer support. 

Dr Nyanga added that structural programmes, which included community mobilisation and dialogues on gender norms, Gender Based Violence (GBV) and harmful cultural practices were also offered as measures aimed at containing the AIDS epidemic. Ends